How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $346.74 Median $3,235.94 Typical High $6,309.57 | Facility | None | $346.74 | $3,235.94 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $346.74 Typical High $457.09 | Professional | None | $263.03 | $346.74 | $457.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,318.26 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $380.19 Typical High $660.69 | Professional | None | $316.23 | $380.19 | $660.69 |
BCBS Kansas City Setting Professional Modifier None Typical Low $275.42 Median $389.05 Typical High $512.86 | Professional | None | $275.42 | $389.05 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,819.70 Typical High $2,187.76 | Facility | None | $602.56 | $1,819.70 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $398.11 Typical High $776.25 | Professional | None | $275.42 | $398.11 | $776.25 |
Medica Setting Facility Modifier None Typical Low $457.09 Median $2,344.23 Typical High $16,218.10 | Facility | None | $457.09 | $2,344.23 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $478.63 Median $2,137.96 Typical High $2,754.23 | Professional | None | $478.63 | $2,137.96 | $2,754.23 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,000.00 | $2,818.38 | $5,495.41 |
United Setting Professional Modifier None Typical Low $346.74 Median $562.34 Typical High $912.01 | Professional | None | $346.74 | $562.34 | $912.01 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $131.83 Median $173.78 Typical High $199.53 | Professional | 52 · Reduced service | $131.83 | $173.78 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $69.18 Typical High $79.43 | Professional | 53 · Discontinued | $52.48 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $257.04 Typical High $302.00 | Professional | 54 · Surgery only | $194.98 | $257.04 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $51.29 Typical High $60.26 | Professional | 55 · Aftercare only | $38.90 | $51.29 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $34.67 Typical High $39.81 | Professional | 56 · Pre-op care only | $26.30 | $34.67 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $239.88 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $181.97 | $239.88 | $281.84 |
Where Missouri sits
The same service costs 4.9 times more in Alaska than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Missouri· 30th of 51
$457
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.